Emergency Radiology ThirdEdition Emergency Radiology Third Edition EDITEDBY Otto Chan ConsultantRadiologist TheLondonIndependentHospital London,UK A John Wiley & Sons, Ltd., Publication Thiseditionfirstpublished2013,©2013byBlackwellPublishingLtd. Previouseditions1995,2007 BMJBooksisanimprintofBMJPublishingGroupLimited,usedunderlicencebyBlackwellPublishingwhichwasacquiredbyJohnWiley &SonsinFebruary2007.Blackwell’spublishingprogrammehasbeenmergedwithWiley’sglobalScientific,TechnicalandMedical businesstoformWiley-Blackwell. Registeredoffice:JohnWiley&Sons,Ltd,TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK Editorialoffices:9600GarsingtonRoad,Oxford,OX42DQ,UK TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK 111RiverStreet,Hoboken,NJ07030-5774,USA Fordetailsofourglobaleditorialoffices,forcustomerservicesandforinformationabouthowtoapplyforpermissiontoreusethe copyrightmaterialinthisbookpleaseseeourwebsiteatwww.wiley.com/wiley-blackwell TherightoftheauthortobeidentifiedastheauthorofthisworkhasbeenassertedinaccordancewiththeUKCopyright,Designsand PatentsAct1988. Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,ortransmitted,inanyformorbyany means,electronic,mechanical,photocopying,recordingorotherwise,exceptaspermittedbytheUKCopyright,DesignsandPatentsAct 1988,withoutthepriorpermissionofthepublisher. Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedastrademarks.Allbrandnamesandproductnamesused inthisbookaretradenames,servicemarks,trademarksorregisteredtrademarksoftheirrespectiveowners.Thepublisherisnotassociated withanyproductorvendormentionedinthisbook.Thispublicationisdesignedtoprovideaccurateandauthoritativeinformationin regardtothesubjectmattercovered.Itissoldontheunderstandingthatthepublisherisnotengagedinrenderingprofessionalservices.If professionaladviceorotherexpertassistanceisrequired,theservicesofacompetentprofessionalshouldbesought. Thecontentsofthisworkareintendedtofurthergeneralscientificresearch,understanding,anddiscussiononlyandarenotintendedand shouldnotberelieduponasrecommendingorpromotingaspecificmethod,diagnosis,ortreatmentbyphysiciansforanyparticular patient.Thepublisherandtheauthormakenorepresentationsorwarrantieswithrespecttotheaccuracyorcompletenessofthecontents ofthisworkandspecificallydisclaimallwarranties,includingwithoutlimitationanyimpliedwarrantiesoffitnessforaparticularpurpose. Inviewofongoingresearch,equipmentmodifications,changesingovernmentalregulations,andtheconstantflowofinformationrelating totheuseofmedicines,equipment,anddevices,thereaderisurgedtoreviewandevaluatetheinformationprovidedinthepackageinsert orinstructionsforeachmedicine,equipment,ordevicefor,amongotherthings,anychangesintheinstructionsorindicationofusageand foraddedwarningsandprecautions.Readersshouldconsultwithaspecialistwhereappropriate.ThefactthatanorganizationorWebsite isreferredtointhisworkasacitationand/orapotentialsourceoffurtherinformationdoesnotmeanthattheauthororthepublisher endorsestheinformationtheorganizationorWebsitemayprovideorrecommendationsitmaymake.Further,readersshouldbeaware thatInternetWebsiteslistedinthisworkmayhavechangedordisappearedbetweenwhenthisworkwaswrittenandwhenitisread.No warrantymaybecreatedorextendedbyanypromotionalstatementsforthiswork.Neitherthepublishernortheauthorshallbeliablefor anydamagesarisingherefrom. LibraryofCongressCataloging-in-PublicationData ABCofemergencyradiology.–3rded./editedbyOttoChan. p.;cm. Includesbibliographicalreferencesandindex. ISBN978-0-470-67093-4(pbk.:alk.paper) I.Chan,Otto. [DNLM:1.Radiography.2.Emergencies.WN200] 616.07(cid:2)572–dc23 2012032717 AcataloguerecordforthisbookisavailablefromtheBritishLibrary. Wileyalsopublishesitsbooksinavarietyofelectronicformats.Somecontentthatappearsinprintmaynotbeavailableinelectronicbooks. Coverimages:Courtesyoftheeditor CoverdesignbyMeadenCreative Setin9.25/12MinionbyLaserwordsPrivateLimited,Chennai,India 1 2013 Iwouldliketodedicatethisbooktomyfamily,myparents,mybrotherBob,mysistersAnaandDiana,mychildren Natalie,Oliver,Sophie,Julia,Marina,CharlieandGeorge,mygrandchildrenElla,LeoandAmber-Lilyandtomyloving wifeZaide. Contents Contributors,ix Preface,xi 1 Introduction:ABCsandRulesofTwo,1 OttoChan 2 HandandWrist,11 JoeCoyle,AliNaraghiandOttoChan 3 Elbow,22 MuaazeAhmad 4 Shoulder,30 AhmedDaghirandJamesTeh 5 PelvisandHip,38 SyedBabar,JamesA.S.Young,JeremyW.R.YoungandOttoChan 6 Knee,49 LisaMeacockandDavidA.Elias 7 AnkleandFoot,59 TudorHughes 8 Head,71 SukiThomsonandAmrishMehta 9 Face,85 SimonHolmes,RavikiranPawar,JimmyMakdissiandOttoChan 10 CervicalSpine,93 LeonardJ.King 11 ThoracicandLumbarSpine,104 LeonardJ.King,AndreasKoureasandOttoChan 12 Chest,111 ArjunNairandIoannisVlahos 13 Abdomen,123 KatiePlancheandNiallPower 14 ComputedTomographyinEmergencyRadiology,135 AnmolMalhotraandJeremyRabouhans 15 EmergencyUltrasound,152 TimFotheringham,OttoChanandIanRenfrew 16 EmergencyPaediatricRadiology,159 R.J.PaulSmith,RosyJalanandMarinaJ.Easty 17 MajorTrauma,171 DominicBarron,SujitVaidyaandOttoChan Index,177 vii